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Washington University Experience | NEURODEGENERATION | Argyrophilic Grain Disease (AGD) | 6A0 Case 6 History
Case 6 History ---- This 82-year-old male was seen only once in September 2006. His medical history was significant for COPD, bladder cancer, hepatitis, hypercholesterolemia, arthritis of the left knee, and prostatic hypertrophy with urinary frequency. The patient’s daughter reported gradual short-term memory changes over eight years including repeating statements and misplacing items. He had developed some noticeable word-finding difficulty. Over time, he had become angrier and depressed. He was rated CDR 0.5, Dementia of the Alzheimer Type (DAT) with depression not contributing. A second reviewer rated him CDR 1 with the same diagnosis. He was placed in home hospice in February 2010 due to COPD and was on home oxygen. He died in May 2010 at age 82 secondary to inanition and aspiration. His CDR at death was 2. He had been placed in a VA psychiatric ward two years previously due to violent behavior, but this improved on medication. In the months prior to his death, he developed spatial problems and hallucinations. Although the patient was seen at the memory and aging project (MAP) only once, mild but gradually progressive changes in memory and thinking over eight years were endorsed at his first visit. In the four years between this visit and his death, it was thought reasonable that AD could progress from a CDR of 0.5 to 2. The disease had a relatively late age of onset, and the patient’s behavioral changes and word-finding difficulty did not become prominent until late in the disease course. ---- At autopsy the fresh brain weighed 1450g.
